Whose Autism?

Something baffling is going on in the States. Well, this isn’t news of course, but this particular weirdness is about autism. What we have is two prominent people in the administration who seem to have completely incompatible views of autism, neither of which seem to bear much resemblance to what actual autism is like. I am of course talking about Elon Musk and RFK Jr.

I’ll do the second first, partly because the clumsiness of referring to Elon Musk makes it quite distracting to write anything about the person concerned due to that person’s pronouns. Robert Fitzgerald Kennedy Junior’s uncle was President Kennedy, and RFK Jr’s the current US Secretary of Health and Human Services. The chief oddities about this guy are that he’s a former environmental campaigner and can be reasonably described as an anti-vaxxer. However, he denies he is one and this makes me feel a connection. He also comes across as a kind of champion for CAM, which makes it complicated.

The reason he denies he’s anti-vaccination is the same as the reason I do, except that for me the reasons for my opposition to certain vaccines are no longer valid. I was concerned about DPT and MMR in the 1990s CE due to the use of thimerosal, a mercury compound, as a preservative in MMR, the presence of formaldehyde in DPT and the use of aluminium hydroxide as an adjuvant in some vaccines. My primary opposition, though, was because it seemed to me that the vaccines didn’t encourage the secretion of the right antibodies. Specifically, I thought they were more likely to generate IgE than IgA or IgM. The claim made by scientists at the time was that IgM was the main antibody generated. The reason I’ve changed my mind is that the method of delivery has changed in a way which encourages IgA and thimerosal is now practically eliminated. I do still have some issues, but on the whole I’ve made my peace with vaccination nowadays. RFK Jr has apparently not done so.

I need to mention something in passing here which might explain why that last paragraph sounds so sketchy. At the start of the Covid-19 pandemic, I decided I would thoroughly hammer my opinions about vaccines with evidence, so I bought two degree-level immunology text books and a further two degree-level microbiology books. I was hoping that these together would enable me to find enough evidence to reassure myself that vaccines were safe and effective. I’m a herbalist, so I had similar education to a third-year medical student in those areas, and was able to build upon that knowledge. Herbalists in general, incidentally, are absolutely not anti-vaccine: this is just my own issue. There’s a whole world of research to be undertaken into the social aspect of vaccine reluctance and refusal which I don’t want to talk about here. So I pursued this route, and rather worryingly, far from confirming my desire to change my own opinions to support vaccination, I found that the more I learned, the more doubtful I became, and this is from standard, mainstream texts on the subjects concerned. I don’t know how this happened, and I also don’t know how immunologists and other relevant healthcare professionals can go through the same learning process and come out the other side in enthusiastic support of them. Having said that, I do have faith that they’re a good thing and therefore I chose to stop researching because the established view is that they’re effective and relatively safe. Consequently, that above paragraph is rather vague as to the details of my issues because I worry that if I now went to those books and studied again, it would cause my opinions to flip into an anti-vaxx position. And I’m sorry, I don’t know why this is.

Back in the day, there was considerable concern about the idea that MMR in particular caused autism, and I was aware of this claim while considering it extremely peculiar. My view of autism at the time was that it was simply the straightforward and more obvious way to think and behave which I didn’t indulge in because I found what would now be called neurotypical interaction an interesting challenge. You might in today’s terms describe my approach as masking, but that has quite a negative connotation. It’s like the difference between running away from a bear and doing a hundred-metre sprint because you enjoy it or you want to. Masking can be exhausting, but it can also be a fascinating, well, the word “hobby” comes to mind except that you have to keep at it. That does, though, require patience and energy. The idea that autism could somehow be caused by the MMR vaccine always struck me as bizarre. The connection made was with the appearance of measles virions in cerebro-spinal fluid and a dramatic rise in IgE. I used to ignore this aspect of it as silly.

It now turns out that the notorious Andrew Wakefield, whom I’ve met incidentally and had conversations on this topic with, was attempting to promote individual measles, mumps and rubella in which he had a financial interest. There was a correlation between the age at which children received the MMR vaccine and the age at which many children were diagnosed with autism because they coincidentally happened at the same time. It wasn’t causation. Since I believe in the scientific method, I changed my mind about it sometime in the 2000s, but my opinions, as usual, are not similar to those of other people, which is frustrating and probably something to do with neurodiversity.

That’s me then, and it means I’ve been there as far as RFK Jr is concerned, except that he is, to say the least, very negative about autism, and has persisted in his belief after thimerosal’s removal from most childhood vaccines twenty years ago. He seems to believe that vaccines, particularly the measles vaccine, cause brain damage. In some cases, this is actually true, because a small minority of the vaccinated do suffer brain damage as a result, but this is the exception rather than the rule. He pledged a few days ago that he would set up a team which would find the causes of autism by September 2025. It should be borne in mind that decades of extensive research have already been done globally into autism and that the causes are currently well-corroborated, in the form mainly of genetics. Hundreds of genes have now been identified which are associated with the development of autism. His view is that autistic people can’t use the toilet on their own, will never get into romantic relationships and basically all the rubbish that Autism Speaks pushes. He says it’s a tragedy for the autistic person themselves, it destroys families, they’ll never write poetry, pay taxes or have a job. A quarter of us are non-verbal, he says. A CDC report did say that a quarter of us face such challenges, but it was on the high end of the estimates and the question of why needs to be raised in a social construction setting. For instance, the reason many of us don’t pay income taxes or have a job is that it’s really hard to crack the code of what neurotypical people expect from candidates or work through the interview process, and for many people once they’re in employment it takes a huge amount of energy to mask all the time and they also face active prejudice. Therefore a lot of us don’t end up paying income tax. It’s not along the lines of recruitment procedures treating neurodiversity fairly, and employers often expect things from people that make no sense to an autistic, like pretending to be busy when there’s nothing to do and expecting some kind of social interaction in particular ways which we feel uncomfortable with and see as pointless. Non-verbal autistic people can be perfectly fine at communicating in other ways, such as online. His view seems to be that we’re damaged, that we’re the people with the problem and not society or neurotypical people and that it’s incontrovertibly some form of brain damage which we ideally wouldn’t have. This is all disgustingly ableist of course, but it’s worth spelling out because of the bizarre disjunct which exists in the current US administration, in the form of Elon Musk’s opinions about autism.

To explain the linguistic eccentricity I’m about to subject you to, here’s a screenshot of something Elon Musk posted on Twitter:

I realise this is some kind of political stunt, but on principle I always try to use the correct pronouns and am going to take this at face value.

Musk, who has made it difficult even to write about fauci because of prosecute’s pronouns, has an equally peculiar but totally different view of autism. In Musk’s opinion, empathy is a failing and only high-testosterone individuals should be able to vote because they are able to develop opinions rationally without tending to make concessions to dominant people around them. In prosecute’s view, this includes “alpha males” and autistic people. In other words, prosecute has for some reason retained the discredited and misunderstood research about alpha males by ethologists and accepts Baron-Cohen’s theory that autism is the result of a brain which has been particularly influenced by testosterone. Further, prosecute seems to accept the rather lazy concept that autistic people lack empathy, and since prosecute sees empathy as a weakness, prosecute sees autistic people as strong in that way.

I should touch on the alpha male myth here. The idea originates from the idea of alpha dog wolves. An alpha male human is supposed to be something like a domineering man who fends off rivals successfully by direct aggression and manoeuvring. The research leading to this idea began in a Swiss zoo in the ’30s because of the near-extinction of wolves in the wild. In this zoo, the purportedly alpha males fought and won over the others and mated more with the bitches and there was then a strict hierarchy with the weak, disadvantaged and starving at the bottom. This research was built on in 1970 by L. David Mech, who popularised this idea. However, Mech continued his research on wolves in the wild and found that they consisted of breeding pairs with puppies, who left the pack after a few years to establish their own packs with their mates. The dominant position of the couple is to do with caring for their offspring because they haven’t learnt to hunt properly yet, and aggression is to do with parents disciplining their children. The only reason the zoo pack was like that was that they were unable to escape their captivity and their society had therefore become dysfunctional. One researcher has said that in thirteen years of observation no incidents of dominance-related behaviour had occurred at all. Mech himself retracted his view in the light of this evidence only a few years after publishing his book. Pecking order, incidentally, is between hens, not the males. In captivity, most wolves breed absolutely fine. When wolves were introduced to Yellowstone Park, they did develop a system like a pecking order but the status of each wolf is fluid and isn’t based on sex. Dog training has been based on the hypothesis, but this is because of the military influence on the practice and has changed in recent years, or so I’ve heard. I’m not a dog person. Anyway, the “alpha male” theory along with pecking order is popular among people who wish to appeal to nature to justify the patriarchy and other forms of inequality, and whereas appeal to nature is fallacious and the concept of nature suspect, there is nothing among well-researched and rationally established studies of wolf or hen behaviour which supports the idea of the alpha male. So there’s that.

As for the extreme male brain theory, this is Simon Baron-Cohen’s idea that exposure to higher levels of androgens in utero lead to a tendency to systematise more and empathise less in the adult brain. Even as it stands, this is a little simplistic although that may be my straw man, because androgen receptors may be more or less responsive to androgens and therefore although there would be a correlation if this is a cause, it doesn’t take different versions of androgen receptor genes into consideration so far as I know. The people who have physiologically had the highest level of circulating androgens during their development are CAIS women, and the reason for this is that their bodies don’t respond to it at all, so their brains won’t do that either. CAIS women have higher androgen levels than men unless treated. But maybe my characterisation is crude.

In his famous paper, Baron-Cohen simply defines a typically female brain as one which empathises more and a typically male one as systematising more, with according lack of the other characteristic. This is related to the idea that autistic people tend to lack a theory of mind, i.e. what philosophers call “the problem of other minds”, and are therefore less empathic because they can’t mentally put themselves in someone else’s position. I have had huge issues with this idea. Firstly, autism in girls and women is seriously underdiagnosed because the kind of masking the patriarchy forces many of us to engage in is different from the kind boys are forced to engage in, and there is as usual a sexist bias in diagnostic tests. Secondly, there are plenty of systematising women. A particularly galling but typical example of this is found in the fact that early on, computer hardware was a man thing but computer programming was considered feminine, which continued until it became clear how valuable it was and men took over. Coding is an excellent example of systematising. It’s more like a glass ceiling problem.

I would also take issue with the, well, issue of empathy. Empathy can be cognitive or affective, i.e. it can involve the emotions or the ability to put oneself in another’s position. One feature of autism is that we tend to filter stimuli less than neurotypical people. If you imagine a child more aware of various sensory stimuli in their surroundings, such as the discomfort of their clothes, the humming of fluorescent tubes, the noise of vacuum cleaners, the dappling of the Sun through leaves and the smell of solvents leaching from housepaint and carpets than average, they may be more easily distracted from the likes of eye contact, nuances in tone of voice or body language and they don’t get to acquire a feeling for such things at an early age. Therefore it may be unfair to expect people on the spectrum to be as aware of what others are communicating compared to those who are more insensitive to such stimuli. It’s simply harder to notice these things. Autistic people are often more empathic than neurotypicals in emotional terms. We can feel carried away or dominated by the feelings of others, which often seem very vivid to them compared to how neurotypical people notice such things. We’re often unable to filter such things, which is hardly surprising because we generally seem to filter less.

However, there’s also cognitive empathy. By the way, although I’m using the terms “affective” and “cognitive” here, I don’t know if that’s what these forms of empathy are actually called in psychology, but the concepts are there. Imagine a world where most people are dramatically unlike you. If you try to put yourself in their position, you’re probably going to get it wrong. To take an obvious example, I love seaweed and dislike chocolate. If I were to put myself in the position of a five-year old such as our granddaughter, I would’ve spared her the Easter egg we gave her and given her some kelp or laver bread instead. Obviously I didn’t do that because I’m aware that most children, at least in England, prefer chocolate to kelp for some strange reason. More widely though, if you’re in a minority and haven’t lived the fully detailed life of a neurotypical person, you’re not as likely to be able to put yourself in their position and anticipate their needs. There’s a case of an undiagnosed autistic man whose wife asked him to organise a CD collection, so he did it in order of dates of birth of the artists because he found them easier to recall than the alphabet, leaving her unable to find anything easily. This is an example of lack of cognitive empathy, but it has nothing to do with not being empathic. It simply means that we’re in the minority, so we can’t do it. Imagining the reverse situation isn’t difficult. For instance, a neurotypical child in a family of neurodivergent adults and children would have the same difficulties.

Hence Elon Musk’s idea of depriving neurotypical people and betas to omegas the vote is not based on a viable theory. Instead, it’s based on some kind of half-understood pop science version of what causes autism, which is probably completely wrong. Nonetheless, prosecute is quite positive about prosecute’s version of what autism is, and this is really strange when you think about what RFK Jr, in the same administration, is saying. Also, as far as I know no conflict has even taken place between the two on this matter.

What is going on?

It isn’t unusual for different politicians in government to disagree on fairly basic points. For instance, Thatcher was famously Eurosceptic while many of her MPs favoured the EEC. But these were usually the source of friction and disunity within the parties concerned. This doesn’t seem to be happening with this, and it reminds me of something else. Benjamin Netanyahu is of course strongly Zionist, so he might be thought to be rather unkeen on the idea of another sovereign state controlling what he considers Israeli territory. However, Trump says he wants to do exactly this with Gaza and Netanyahu is enthusiastic about it, so what the heck is the Israeli-Palestine conflict supposed to be about?

I have the impression that all of these things are strongly-held opinions, and moreover that they’re sincerely held by both parties. In Musk’s case, there seems to be a history to this as prosecute once claimed to be a utopian socialist, for example. Maybe prosecute thinks prosecute’s sincere about prosecute’s beliefs but they somehow don’t penetrate. It’s almost like playing, which may not be a bad thing except for the thousands of millions of lives involved, including future ones. But I’m having serious difficulties in trying to understand what this is about and how it can happen. I feel I’m missing something quite profound here, in that it doesn’t seem to matter what either of them believe, but it does remind me of something: the idea that people don’t want the truth or well-supported evidence to persuade them that something is so because they have some kind of unsupported abstract idea of “The Truth” which cannot be assailed.

I’ll sum up Musk’s position as “autism = (testosterone + IQ) – compassion”, and RFK Jr’s as “autism = toxins + corruption – accountability”, in that some group is presumably going to be held responsible for what he thinks of as an increase in the incidence of autism. Some kind of chemical environmental factor has, in his view, led to autism. His narrative is one of damage. Musk’s is one of a superpower caused by testosterone. So they do have something in common, in that both of them believe autism is caused by a class of organic compounds, if, that is, it’s to do with thimerosal. To one of them autism is a crime scene and to the other it’s like the X-Men. They both seriously misunderstand what autism is, and maybe that’s the key.

Is it possible that this kind of contradiction can arise because people don’t trust experts and think they know better than they really do without having put the effort in? I keep finding myself coming back to the same conclusion in these posts, that it’s always to do with people thinking they know better than experts, and that it’s being perceived as a contest between individuals who are simply winners or losers, regardless of the validity of their policies, and also that they’re not interested in evidence, no matter how good its quality is.

I think their alliance is based on mutual benefit. Neither of them are in touch with reality and they’re living in their own little worlds, but both of them are fine with their apparent positions of power. But it’s empty power as usual, because they can’t effectively act on their views. Both of them are dehumanising. Musk seeks to put the dehumanised in influential decision-making positions without rehumanising them and imagines that such people are autistic, and RFK Jr simply says they shouldn’t exist at all and that they’re some kind of mistake. The result of both would be suffering on an enormous scale, so they have that in common.

I don’t know. I’m sure it makes sense politically but it sure as heck doesn’t in any other way, but I can’t help thinking this is part of the design, that it’s a feature rather than a bug. I just can’t see how.